Do You Have These Early Hashimoto's Thyroiditis Symptoms?

Hashimoto’s thyroiditis¹ (also called Hashimoto’s disease and chronic lymphocytic thyroiditis) is an autoimmune disorder involving the thyroid.

It’s the leading cause of hypothyroidism (an underactive thyroid) in developed countries, affecting 2% of the population. Women are at least seven times more likely² to receive a Hashimoto diagnosis than men. 

First signs of Hashimoto’s thyroiditis

Many people with Hashimoto’s will have no symptoms for years, with the condition gradually causing damage and limiting your body’s thyroid hormone supply. 

When you start to show symptoms, these are usually associated with either goiter or hypothyroidism, the two main complications of Hashimoto’s. 

Goiter

Goiter is an enlarged thyroid,³ which, in this case, is caused by insufficient hormones. The pituitary gland in your brain creates more thyroid-stimulating hormone (TSH) in response, causing your thyroid to swell.

When you have a goiter, you might feel fullness in your throat.  The front of your neck may look swollen, and you might find it harder to swallow or breathe as the goiter grows.

Hypothyroidism

Hypothyroidism, also known as underactive thyroid, occurs when your thyroid gland does not make enough hormones crucial to your body’s functioning. People may not immediately notice its symptoms, but more problems can develop if left untreated.

Other symptoms of hypothyroidism include the following:

• Fatigue

• Weight gain

• Joint and muscle aches or weakness

• Constipation

• Dry skin or hair loss

• Voice hoarseness

• Depression

• Cold intolerance

• Irregular or heavy periods or fertility issues

• Decreased heart rate

• Cognitive changes, e.g., forgetfulness, depression 

However, many conditions can cause these symptoms, so Hashimoto’s can be tough to identify straight away. 

What causes Hashimoto’s thyroiditis?

Your immune system fights viruses, bacteria, and anything that can harm you. As Hashimoto’s thyroiditis is an autoimmune disorder, the body’s immune system mistakes healthy thyroid cells for harmful invaders, attacking them. 

Doctors still don’t know why the immune system does this. However, risk factors predispose some individuals to this medical condition.

Here are some of those risk factors:

• Being female

• Between 30 to 50 years old

• Family history of thyroid problems

• Pre-existing autoimmune condition

How is Hashimoto’s disease treated?

The primary treatment for Hashimoto’s is levothyroxine,⁴ a synthetic version of thyroxine, the hormone your thyroid makes. You need to take levothyroxine daily for the rest of your life. 

Your healthcare provider will need to test your TSH level regularly to ensure you are adequately treated. Although the medication starts working immediately, your symptoms might take a few weeks to settle.  The frequency of monitoring decreases to roughly every 6 to 12 months once you have been established on the correct medication dose.  

Certain things can affect your TSH level during your treatment. These include medications that affect levothyroxine absorption, such as calcium carbonate, aluminum-containing antacids, sucralfate, iron supplements, cholestyramine, and sevelamer. This is why your TSH levels will need regularly checking, even after you’ve taken levothyroxine for years.

Levothyroxine is safe to take during pregnancy, and your doctor will need to increase your dosage to ensure your unborn baby develops appropriately. You will have regular thyroid level checks during pregnancy to ensure you take the correct dose of levothyroxine. It’s also safe to breastfeed while taking levothyroxine.

Never stop taking your medication, and don’t take too much, as this can cause serious side effects like osteoporosis and atrial fibrillation (irregular and fast heartbeat). 

If your thyroid hormone levels are normal, you will not need treatment. 

What happens if Hashimoto’s thyroiditis isn’t treated?

If you have hypothyroidism caused by Hashimoto’s, leaving it untreated can cause serious complications:

• A huge goiter causes compression, which can lead to breathing and swallowing issues

• Mental health issues, including depression, low libido (sex drive), and brain fog

• Heart problems, such as heart failure or an enlarged heart

• Myxedema coma is a life-threatening condition caused by long-term untreated hypothyroidism

• If you’re pregnant with untreated hypothyroidism, your baby is more likely to be born prematurely, have a low birth weight, a lower IQ, have congenital disabilities, or be stillborn

Can Hashimoto’s thyroiditis be cured?

While there is currently no cure for Hashimoto’s thyroiditis, levothyroxine can regulate your hormones and restore your metabolism. 

A study⁵ in 2021 showed that metformin could reverse Hashimoto’s, but the researchers admit it’s a small-scale study with limitations. They also used animals in the study rather than testing their hypothesis on human participants. 

Metformin is a drug for type 2 diabetes. Scientists are investigating it as a possible treatment in several other areas, including multiple sclerosis, inflammatory bowel disease, and rheumatoid arthritis. 

There are also clinical trials for Hashimoto’s, including understanding certain symptoms like alopecia, the causes of the disease, and the development of new drugs. 

The lowdown

Hashimoto’s thyroiditis is an autoimmune disease affecting the thyroid gland. People diagnosed with Hashimoto's disease usually take medication for hypothyroidism, which is thyroid hormone replacement therapy.⁶ 

Since your thyroid gland is not producing enough of the thyroxine hormone, you must take levothyroxine medication daily. It is the synthetic version of thyroxine, and once you have adequate hormone levels, the symptoms will eventually disappear.

However, you will need to take levothyroxine daily for the rest of your life to keep your hormone levels balanced. Your TSH levels must also be monitored regularly (annually or depending on your doctor) to adjust the dosage as needed.